1. Purchase refurbished or demo capital equipment. While some capital equipment should be purchased brand new, Ms. Arrambide says surgery centers can save money by purchasing some demo, remanufactured or refurbished equipment. “There are options out there for demo equipment that may have only been used a few times,” she says. “Companies can sell you demo equipment at a reduced price and give you the same warranty that comes with a new piece of equipment. Other companies offer refurbished equipment and you can recognize huge savings over new.”
When you talk to sales reps, she recommends asking for a quote on a particular piece of equipment, then asking if the company has options for demo or refurbished equipment. She says she usually has to ask sales reps for the option of demo or refurbished equipment, but once she does, the companies are usually willing to work with her. In addition, they should give you the book price, the GPO price and then your price.
2. Consign implants. Because implants are such a significant cost to Ms. Arrambide’s ASC, she worked hard with her vendors to consign implants. “We have told them, ‘We’ll use your product, but you have to consign to us,'” she says. Implants can be so expensive that you don’t want to purchase them and then let them sit on the shelf.
3. Look at shipping costs. Ms. Arrambide advised ASC administrators to examine shipping costs and other additional hidden costs when negotiating with vendors. She says some vendors may exempt the ASC from paying shipping, or the center may be able to choose ground shipping rather than express delivery for supplies that are not urgent.
4. Consider generic implants and supplies. Ms. Arrambide said some implants and supplies are becoming available under a different name with no difference in quality. Think of impalnts and supplies moving the same way as generic drugs. “There are huge savings to be captured when you are experiencing implants not being reimbursed” she says. It means sales reps are not in the OR suite, but they are not always necessary. Implant costs are driven largely by the cost of the sales reps presence. You can now buy direct from the manufacturer. She encourages all center to do cost and outcomes studies.
5. Take advantage of distributor reward and rebate programs. Ms. Arrambide recommends building a strong relationship with your vendors and distributors to make sure that you achieve all possible savings. “We work very closely with our distributor,” she says, reviewing our usage and GPO contracts, making sure we get the best tiered pricing. “Most distributors have reward and rebate programs for loyal customers, so make sure to ask your representatives and apply for all available discounts.”
6. Review custom packs. The supplies that come in custom packs need to be reviewed by the OR team on a regular basis. “The custom pack contents changes as preference cards change and you find yourself opening items that should be in the packs or discarding items no longer used,” Ms. Arrambide says. “In addition, your ASC should look at other vendors to make sure you are getting the best deal on your custom packs.”
7. Post PAR levels. You can prevent supply hoarding in your ASC by posting PAR levels on your shelves and bins, Ms. Arrambide says. “I’m a nurse, and I know that nurses really want to make sure we have all the items we need for each case. We don’t want to run down the hallway and get something, delaying the case” she says. “We tend to packrat things and stock containers more full than they need to be stocked. It increases inventory and supply costs.”
Determine the correct level for supplies in each area and post those PAR levels to let staff members see the expected stock levels. Ms. Arrambide says most ASC administrators do “just in time” ordering so they don’t run out of supplies to begin with.
8. Reprocess when possible. Ms. Arrambide says ASCs can recognize a 50 percent savings on equipment by reprocessing supplies with an FDA-approved reprocessing company. She recommends doing thorough research into approved companies and applicable laws and then sending appropriate items for reprocessing whenever possible.
9. Track expiration dates. During quarterly inventory, Ms. Arrambide’s staff flags items that are approaching expiration. She suggests setting up a “show and tell” table or a list of supplies so people know the near-expiration items and try to plan to use them before they expire. “That gives us a 3-6 month lead time for all supplies,” she says. “For implants, we do it six months in advance of the expiration date because the cost.” This process also allows ASC leaders to determine which items should be re-ordered, and the quantity needed.
10. Post supply and case costs. Ms. Arrambide recommends posting supply costs in your ASC to help physicians and staff understand costs. “It can really be an eye opener when people start reading exactly what we pay for items,” she says. When her surgical team starts a case, the team members do not open every supply immediately, but instead hold them on a cart until an item is necessary.
“We help staff understand that you don’t open something for a case until the case warrants it,” Ms. Arrambide says. She says preference cards should also be kept up-to-date so that staff members don’t open or stock supplies that the physician no longer uses.
Related Articles on Surgery Center Supplies:
GES’ New MRI Machine Gets FDA Approval
Northwestern Researchers Compare Findings With IOM 510(k) Report
FDA Grants Nipte $35 Million to Reform Drug Manufacturing Process
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
